As the saying goes, an ounce of prevention is worth a pound of cure. In American culture, I believe prevention is perhaps the most under-valued tool in medicine. Many chronic diseases can be prevented or treated earlier with screening. So what tests do you need? This can be confusing, because guidelines have been changed recently for women.
Below, I’ve outlined the recommended screening exams for women:
Cervical Cancer: For 21-29 year olds, the American College of Obstetrics and Gynecology (ACOG) recommends a pap smear every 3 years if the results are normal. This is different than previous guidelines recommending screening yearly. For ages 30-65, you have two options; a pap smear AND HPV testing every 5 years or a pap smear every 3 years. You will need more frequent screening if you have HIV or have been exposed to DES.
Breast Cancer: Mammograms from ages 40-49 have become quite controversial. Currently, I recommend a mammogram if you have a strong family history of breast cancer. So what does that mean? If you have 2 first degree relatives with breast cancer or if you’ve had 2 previous breast biopsies or if you have 1 first degree relative with breast cancer AND you’ve had 1 biopsy, puts you in that category. You also should have a mammogram if you’ve ever had DCIS, breast cancer, atypical hyperplasia, or chest irradiation. If you are BRCA+, you should also have mammograms. Otherwise, mammograms are recommended for 50-74 year olds every 2 years. This is also a change, as mammograms were previously recommended yearly. (Schedule your mammogram online today!)
Colon Cancer: Start at age 50 with a colonoscopy. You will need to start earlier if you have a family history of colon cancer. Discuss timing of your first colonoscopy with your PCP.
Diabetes: Screening recommended if your BP is >135/80.
Cholesterol: Start at age 20 if you smoke, have diabetes, hypertension, heart disease or are obese (BMI>30). You should also be screened if you have a family history of a male <50 years old or a female <60 years old with heart disease.
Osteoporosis: DEXA scan starting at age 65 years old or earlier if you have risk factors such as being underweight, having a family history of hip fractures or use steroids chronically.
Hepatitis C: The latest recommendation from the CDC (Center for Disease Control) recommends screening all baby boomers born from 1945-1965. 1 in 30 baby boomers have the disease and don’t know it. (Learn more at the Liver Institute of Virginia.)
HIV: Everyone who is sexually active should be screened.
Depression: Consider screening if you have ever felt sad or hopeless and you have lost interest in your usual activities or hobbies.
About Dr. Susan Szulc
Susan V. Szulc, MD, is a board-certified internist with Bon Secours Medical Associates at Virginia Beach. She received her bachelor of science in microbiology from the University of Florida in Gainesville, Fla. Dr. Szulc earned her medical degree from Eastern Virginia Medical School (EVMS) in Norfolk, Va., where she also completed a residency in internal medicine. Dr. Szulc is board certified by the American Board of Internal Medicine. She is a member of the American Medical Association, American College of Physicians and American Medical Women’s Association. Dr. Szulc’s special interests include palliative care and hypertension.
Source: US Preventative Task Force Guidelines and American College of Physicians